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A guide to enhancing your natural beauty

Redefining YouRself15 FEBRUARY 2009

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Redefining YouRself

CONTENTSResearch & innovation 4-5

Cosmetic dentistry 6

Anti-ageing 8-9

Spas 10Non-invasive

procedures 12-13

Hair loss 14-15

A TITLE FROM MEDIAPLANETREDEFININg YOuRSELF

Project Manager: Rosie BarbourEditor: Emily DaviesProduction Manager: Katherine WoodleyDesign: Sherine BarnesPrepress: Jez MacBeanPrint: Telegraph Media group Ltd

Mediaplanet is the leading European publisher in providing high quality and in-depth analysis on topical industry and market issues, in print, online and broadcast.

For more information about supplements in the daily press, please contact Simon Kenneally Tel: 020 7563 8897simon.kenneally@mediaplanet.comwww.mediaplanet.com

The industry has expanded with the times and now includes everything from pills to peels. “Cosmetic medicine” today describes everything on offer for rejuvenating and reviving, from laser therapy to chemical peels, facials featuring an hour of massage and infra-red light, injectable fillers, embryonic stem-cell work and hormone therapy, as well as the surgeon’s knife.

And it is growing at a rapacious pace: the market research group Mintel predicts that by 2010 the British cosmetic industry will be worth more than £1 billion – almost double its current value.

It can even be holistic, treating the whole body; it can be from the

inside out, using supplements and Chinese medicine - the line between the professional and the amateur was blurred long ago.

The shelves of Boots, beauty boutiques and department stores are overrun with dermatologist-labelled brands: Dr Lowe, Dr Lens, Dr Brandt, Dr Gross, introducing to bathrooms the same kind of skincare previously confined to their offices, albeit at a reduced potency, in line with prescription laws, and a commensurately reduced price.

Developments in skincare science now mean that many treatments previously available only from the dermatologist or the cosmetic surgeon are now available at home,

or in salons and spas.Some carry more risk than

others. Dr Patrick Bowler, a leading cosmetic doctor and former chair of the British Association of Cosmetic Doctors, says that when approaching a professio-nal in this field it is more important than ever to be on guard – and informed.

According to Dr Bowler, European Union regulations state that the use of procedures and potions is legitimate if they can be shown to be safe – it is not necessary to prove that they work. In the UK, the Healthcare Commission, which regulates some areas of cosmetic medicine, has guidelines on what to look for – and on what is not regulated by them.

While cosmestic medicine as a whole is expanding, the field of minimally invasive treatments is enjoying particularly spectacular growth. In straitened economic times it is the area that is considered to suffer least – on the basis that the big stuff can wait but the maintenance needs to continue.

Of course, one person’s “mainte-nance” is another’s excess; but at the end of last year a survey of pa-tients’ spending habits in cosmetic medicine by the American Society of Plastic Surgeons found that 73 per cent of the doctors they spoke to saw an increase in demand for procedures such as Botox, chemi-cal peels and hyaluronic-acid or similar dermal fillers.

“It appears more consumers are choosing the less invasive cosmetic procedures, both to give them a boost or to buy time if they need to postpone a more costly invasive surgical procedure because of the

economic downturn,” says Dr Richard D’Amico, president of the ASPS.

For women in the UK, the top cosmetic surgery is breast augmentation, followed by liposuction. Men, increasingly exposed to the “top-down” acceptability effect of celebrity endorsement, are not immune to the vagaries of vanity either. Male-specific procedures and their high-profile fans include Dysport, the “male Botox”, and Simon Cowell; undereye-bag lifting and Silvio Berlusconi and jowls removal, Diego Maradona.

No area is left untouched by the rosy-tinted reach of cosmetic medicine. In the more pampered parts of Manhattan and Los Angeles, even toes are redefined and restructed (accompanied by the plumping of soles with collagen, all the better to withstand the ache of high heels).

But whatever your procedure or potion of choice, redefining yourself certainly does not have to be dramatic – or painful - to be successful.

The benefits felt in the most velveteen corners of Harley St often began in a dusty, dirty field far away – and as a result of some of the most horrific injuries imaginable.

Often born on foreign battlefields or the bloody streets of inner cities, developments in plastic and reconstructive surgery have always pushed the most comfortable areas of cosmetic and aesthetic medicine to the forefront of surgical innovation. The demands of the skin and the soul are the same – and sometimes it is even the same doctors.

Just occasionally, it works the other way. For instance, the hyaluronic-acid dermal filler Sculptra, developed to fill

and plump facial lines, is also used to give the appearance of volume to the depleted muscles in AIDS victims.

Cosmetic medicine might seem a paradoxical term. Certainly, it is often assumed to have a darker side that lives in Hollywood back streets, in clichés and some truths.

Indeed, Dorian Gray Syndrome was first described by the German doctor Burkhard Brosig in a paper published in the International Journal of Clinical Pharmacology and Therapeutics in 2001 - “Dorian Gray Syndrome and other fountains of youth” – in which he estimated that three per cent of Germany’s total population suffered from a problematic “search for eternal beauty”.

Introduction

The battle for beauty

“The market research group Mintel predicts that by 2010 the British cosmetic industry will be worth more than £1 billion”

War wounds and facelifts: it would be easy to think the two could not be further apart. But of all areas of medicine, they share far more common than many realise.

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HR management Incontinence

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Redefining YouRself

the Golden Ratio in the belief that it is the most aesthetically pleasing.

But Marquardt’s technique, called Beauty Analysis, defines beauty by mapping the Golden Ratio to create a mask of perfect proportions from which surgeons can work.

Marquardt’s crucial initial disco-very was that the combined width of the two upper front teeth in a model-perfect smile is 1.618 times the height of each tooth. Eventually, he decided to use the concept of phi to build a template for the whole face.

Using a computer, he generated a number of shapes using key facial features as starting points. The sha-pes that resulted were all based on

the 1:1.618 ratio, from which he cre-ated a “mask” of ideal beauty: the “phi mask” upon which he builds new faces for his clients.

Not all developments in aesthe-tic and cosmetic surgery are quite so poetic. Vavelta, a new treatment developed by the British biomedical company Intercytex, uses skin cells from newborn babies’ foreskins to rejuvenate facial skin. Vavelta’s most radical feature is that it seems to re-structure ageing and damaged skin from the inside by repopulating the lower layers of the skin with millions of healthy young skin cells; and, un-like fillers and Botox, the procedure is considered permanent.

The tiny skin cells, or fibroblasts, are derived from baby’s foreskins do-nated by mothers at a hospital in the US after routine circumcision and which would otherwise be discarded. Both mothers and babies are screened before the foreskins are used.

Once in Britain, they are divided into microscopic pieces and treated with enzymes to release the fibro-blasts – these are then grown in la-boratories, a process monitored by the Food and Drug Administration in the US and by the Human Tissue Aut-hority in the UK. Fibroblast cells are responsible for the maintenance of youthful skin, producing collagen to create a smooth complexion. As the

One of the newest and most innova-tive methods of cosmetic surgery is founded on a very old ideal of perfec-tion indeed.

Dr Stephen Marquardt, a re-constructive surgeon from Southern California who has made a career of studying the mechanics and of beauty, has derived a mask from the Renaissance concept of the Golden Ratio – which, he claims, represents the ‚ “ideal” facial archetype.

Marquardt is not the first to be engaged with the concept of phi, or the geometric concept of the Golden Ratio; since its evolution during the Renaissance, many artists have deve-loped their work to the proportion of

skin ages, they become dormant and many die.

Dr Patrick Bowler of the British Association of Cosmetic Doctors says the technique appears to be highly effective at treating conditions for which presently there is no other ef-fective solution, such as acne-scar-ring or any depressed scars. And, un-like with laser treatments, there is no need for recovery time.

Other groundbreaking work is un-der way to improve the way we use what we already have. At the Ame-rican Society of Plastic Surgeons’ (ASPS) and the American Society of Maxillofacial Surgeons’ Plastic Sur-gery (ASMS) 2008 conference last

Research & innovation

In search of the perfection formulaFrom the Golden Ratio of the Renaissance to a technique certain to make you smile; cosmetic innovation knows no bounds.

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Redefining YouRself

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ADSNew.indd 1 7/2/09 09:05:33

Research & innovation

November, new “facial reanimation” procedures were revealed as a result of research by the Facial Nerve Pro-gram at Duke University.

“A smile is a universal greeting,” says Dr Richard D‘Amico, president of the ASPS. “Unfortunately some people cannot smile, or are too self-conscious to do so, either because of a defect, droopiness or wrinkles around the mouth, or protruding gums. The inability to smile is devastating.”

“Facial reanimation” consists of either one or two microsurgical pro-cedures that involve connecting a specific nerve in the face to a trans-ferred functional muscle grafted from the leg. The nerve serves as an energy source while the muscle acts like a motor to create the motion nee-ded to smile.

For a patient who can‘t smile on one side, a nerve graft, taken from the back of the calf, is connected to the nerve on the functional side of the face and extended to the paraly-sed side - the nerve graft acts like an extension cord providing electrical currents to the paralysed side.

Six to twelve months later, after the nerve on the paralysed side be-comes “live”, the muscle is connected and its artery and vein are attached to vessels in the face. Typically, for a patient who can‘t smile on both sides, the muscle is transferred and atta-ched, in one procedure, to a nerve found on both sides of the face that is not usually used to smile, but is re-sponsible for chewing.

“Facial reanimation surgery gives those who never could smile, or those who have lost the ability to do so, the power to communicate,” says Dr Jef-frey Marcus, the surgeon who initia-ted the course at Duke University.

Another area rich in change is bre-ast augmentation, which is the most common cosmetic procedure in the UK, according to the British Associ-ation of Aesthetic Plastic Surgeons. 8,449 breast enlargement operations were performed by its members last year, a 300 per cent increase on the amount performed five years ago.

Several recent advances in breast-augmentation technology and tech-nique have made it even more possi-ble to achieve a natural look with the procedure.

All breast implants rely on a shell - the outer part of the implant - and a filling, which is usually silicone gel. Recent developments in implants in-clude a new tear-drop shape, a more natural form suited to slim women with the aim of creating a more na-tural shape.

“The most important goal of breast enlargement must surely be to achieve a natural look,” says Dr Rajiv Grover, secretary of BAAPS. “If there is a reasonable amount of breast tissue to start, usually a B cup or larger, then inserting a bre-ast implant means it will be covered by a reasonable thickness of your body’s own tissue, giving a smooth and natural outline.”

On the other hand, if the chest is thin and the patient has only a small amount of tissue, the implant may look “stuck on”, with a visible outline to the upper half of the implant. The newer tear-drop shaped implants re-duce this effect by giving a gentler slope to the upper part of the breast.

Advances in the technology of sili-cone have led to a “cohesive” silicone gel that does not leak even if there is a break in the implant’s shell, and a new texture adapted to the body to

reduce its reactions to implants.“One the most important long-term

problems with breast implants was hardening, where the body produced a capsule around the implant rather than the usual thin film of membra-nous tissue seen when any foreign material is inserted in the body,” says Dr Grover.

“This used to affect one in five women with implants and was found to be related to the fact that implants used to have a smooth surface. The advent of a textured surface to the implant reduces the body’s reaction to implants and so the rate of harde-ning over the first ten years has dra-matically reduced to one in 20.”

New methods in breast enlarge-ment also strive for an even more

naturalistic look. The “dual-plane” technique is a way of providing a mo-dest lift during breast enlargement with implants without leaving scars on the breast – the implant is placed under the muscle but the breast tissue is lifted slightly from the muscle so that the two can glide on each other, achieving a modest lift for women

who may need this as well as an en-largement.

For the renowned London facia-list Sarah Chapman, “There are con-stantly so many ingredients being modified and new techniques inven-ted”, that it would be impossible – and inadvisable – for anyone to embrace them all.

Chapman names enzyme techno-logy, peptides and the antioxidant

resveratrol as expecially interesting developments to watch, along with new inventive techniques with exi-sting products.

“With surgery the minor tech-niques are evolving to offer more results with minimally invasive treatments,” she says. “Doctors are becoming more experimental with Botox and fillers and many are using vitamins via injection all over the face for rejuvenation. This is not new but it’s an additional way to enhance penetration of key in-gredients such as vitamin A and C”.

Both Dr Bowler and Chapman highlight the emerging importance of ultrasound technology. Though hardly a new technology in its own right, it is now being used to enhance facial and body treatments - in con-junction with liposuction, for in-stance, on the body and with electri-cal stimulation on the face.

Such use of a well-established technology in new and innova-tive ways is an example of the industry’s prescient-thinking that is pushing research and develop-ment ever forward.

“There are constantly so many ingredients being modified and new techniques invented”

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Redefining YouRself

more rounded shape – less of the harsh, squared-off look from before – and, as a result, perfectly flawed veneers are being constructed accordingly.

“The problem I‘ve found is that if you put perfectly shaped perfectly white teeth on most faces, you ruin the face,” says dentist Harold Fray, a dentist in California. “The con-trast of perfection and normality is just too harsh.”

One guideline offered by dentists is that teeth should be no whiter than the whites of the eyes. Catherine Low, a 36-year-old executive assi-

Today, even the most modest phar-macy offers brightening toothpastes, and high-street salons everywhere advertise lunch-hour teeth white-ning.

But much of what makes a great smile has to do with more than just a bright, dazzling hue – the alignment, the shape, the size and even the tex-ture of your teeth all play a signifi-cant role.

A great smile is now seen as the re-sult of a whole package, which could involve a treatment as straightforward as whitening or as complex as an imp-lant - although whitening, it turns out, is no longer necessarily that straight-forward.

It used to be a simple request: make them as white and as bright as pos-sible. But the latest dental trend in America, which British dentists say is a decade ahead of the UK in such matters, is a more naturalistic white, evoking a kind of believably flawed perfection in contrast to the immacu-lately white smile more traditionally favoured.

Now, a spokesman for the American Dental Association explains, many patients want more translucency on the edges of their teeth, a gradation of colour from the top to the bottom and even a very slightly off-centre positioning of the tooth. They are also seeking a

stant, asked Dr Fraw for two shades below the recommended shade du-ring her recent teeth-whitening.

“The brightest just isn’t the most flattering – and it’s definitely not be-lievable,” she says. “It looks too fake, which to me is as unattractive as wea-ring artificial nails”.

However, almost half of Dr Fray clients still ask for teeth “as white and shiny as I can do them”, he says.

Cosmetic dentistry

“They just can’t get enough.”Many people, says Dr Kimberly

Harms, a consumer adviser for the American Dental Association “now have teeth that are whiter than the normal colour scale we used to use a few years ago.

“We now have many people whose teeth are whiter than the [official] tooth colour scale.“

Dentists refer to the skewed per-spective which causes patients to stop detecting the true whiteness of their teeth and push for further bleaching, as “bleachorexia”.

“Whiter teeth are far more standard now, and people think there is no such thing as too white,” says Dr Fraw, who points out the trend for thick, imma-culate teeth began with the desire to emulate celebrities who had them be-cause they looked so good on screen.

“They get used to seeing their teeth every day and don’t know when to stop. They start to want to take their teeth way beyond what looks natu-

ral.”But the desire for a dazzling smile predates the demands of cinema. Ancient Egypti-ans bleached their teeth with ground pumice and vinegar, while the Romans are thought to have used human urine.

Fast forward a few hundred years and the techniques are about the only thing that has change. American dentists began lightening teeth with hydrogen peroxide in the 1980s and the end of that decade saw the introduction of the first take-home bleaching kits - custom-made trays, similar to mouthguards, filled with carbamide peroxide.

In addition to whitening, there are solutions to match every percei-

ved imperfection. With bonding, a composite resin (a malleable tooth-coloured material) can be used to cor-rect gaps, crowded teeth, stained and chipped teeth or fillings on teeth.

Veneers, made of ultra-thin porcelain, can be bonded to the front surface of teeth to correct size, shape and colour concerns. They are ex-ceptionally strong and stain-resi-stant. Implants that replace missing teeth are inserted under anaesthetic during surgery.

New developments in periodontics – the branch of dentistry concerned with the teeth’s supporting struc-tures - include a gum lift, which involves sculpting or reshaping the gum line to achieve a balance bet-ween the degree of gum visible and the teeth. Gum de-pigmentation in-volves the removal of black spots or patches on gums caused by the pig-ment melanin.

At-home treatments have outstripped the now-pedestrian whitening toothpaste to bring a professional-style service into your bathroom - and without the need for needles. Colgate offers a toothpaste intended to replicate the hygienist’s magic – Total Professional Weekly Clean contains the same cleansing ingredient dentists use, and brigh-tens teeth considerably by removing surface stains.

Of course, the art of illusion goes a long way. Beyond the dentist’s chair, Hollywood still has tips for an im-peccable smile: to enhance the ap-pearance of teeth, leading film and television make-up artists advise a subtle swoosh of bronzer and a blue-based red or pink lip colour; avoid orange-based shades, which could make them look less white.

How to win that smileThe Hollywood smile – dazzling white teeth perfectly offset by healthy pink gums and smooth lips – has become an established part of the modern beauty armament.

Create the Smile of your Dreams!The clinic was established in Gozo, Malta in 1985. It is a complete dental

and oral health centre, a friendly, state-of-the-art practice dedicated to

Comprehensive Quality Dental Care. In 2006 Savina Clinic was accorded

International Visiting Centre status for ZIMMER ® Dental Implants (Cali-

fornia, USA) The Principal, Dr Joseph Xuereb BChD(Hons), MFGDP(UK),

MGDS RCS(Eng), FFGDP RCS(UK) FICD is a Fellow in General Dental

Surgery of the Royal College of Surgeons of England, Fellow of the

International College of Dentists and Key Opinion Leader for Oral B and

Crest Worldwide.

Dr Romina Camilleri BChD(Hons)qualified in Malta in 2004 and

joined the practice to concentrate on children’s dentistry, conser-

vation and endodontics. Oral Hygiene, spa-style ZOOM!® Tooth

Whitening and Fresh Breath clinics are conducted by our resident

dental hygienists.Our Clinical Team is committed to continuing

education programs in order to keep up to date with techniques

and materials to provide our patients with the treatment and

services they desire.

All surgeries are fitted with the latest equipment for optimum patient

care and comfort. Digital radiography and CT scan elaboration software

allow detailed and accurate

implant surgical treatment

planning. Every member of the

team is trained in the necessary

cross infection procedures

recommended by the British

Dental Association to ensure

complete safety and patient confidence. Our sterilization procedures are

of the highest quality and are continually monitored.

We can improve your smile by: straightening your teeth, irrespective of your age

hiding or masking unsightly stains

closing gaps

re-building fractured, worn or malformed teeth

replacing unsightly black fillings

replacing missing teeth

whitening (bleaching) your teeth using the state-of-the-art ZOOM! ®

wrinkle-filling and lip enhancement using Evolence ® and Artecoll ®

injections

In collaboration with our visiting consultants, we offer comprehensive expertise and experience in: Oral Surgery

Root Canal Treatment

Complex Restorative, Occlusal and Periodontal cases

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Complete range of Implant treatment including Bone Grafting/

Augmentation

Child and Adult Orthodontics including Invisalign®

Immediate Implant-borne Toronto Bridges

Specialist local and foreign laboratories are engaged to supply state-of-the-art: Acrylic, Chrome and Titanium dentures

Crown and Bridgework in precious metal/porcelain, gold, titanium and

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Precision attachment-retained partial dentures

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Porcelain inlays and veneers, Lumineers®

Occlusal splints for bite problems

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7 Sir Adrian Dingli Street Victoria VCT 1441 gozo MaltaTel (+356) 21 557323, 27 557323 Fax (+356) 21 550323reception@savinadental.com www.savinadental.com

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lot to choose from to get the best.A lot of dentists seemed more

interested in their own stereotyped quick fix rather than correcting her teeth. That was until she met Parag Patel and Dr Dinesh Vegad at LXIR, the men who she came to dub as “Dental Artists”.

LXIR is a Harley street practice with a branch in Birmingham with a new vision; six consultants specialising in all different aspects of cosmetic dentistry all under one roof. Their mission is “total patient care” and they believe that the combination of their expertise provides the ultimate dental experience.

After a couple of meetings with Dr Parag Patel & Dr Dinesh Vegad , Sofia chose to go ahead with LXIR. Dr. Patel brought in Dr Soneji , an implantologist with over 20 years experience.

Several wax models of her teeth were created to show her what options were available. Not only could she choose the shape and size

of her teeth, she also got to see a variety of colours as well. This was important to her, because like many others she felt that a smile “accentuates your individuality”.

Initially she had wanted both her upper and lower teeth fixed, but Dr. Patel convinced her that her lower teeth were fine as they were and that only teeth whitening was required. This also struck Sofia, because she had assumed that the surgeon would rather do an unnecessary procedure to earn more money rather than tell her that it wasn’t necessary.

Dr Patel and Dr Vegad first made a trial smile with composite veneers so she could try out her new teeth before making any permanent changes. LXIR do this

Have you ever longed for a celebrity’s smile but felt it was be-yond reach? Next time just remem-ber one thing, even the rich and famous aren’t born perfect.

The seemingly FLAWLESS Sofia Hayat is one of the hottest British actors around today. Often filmed at red carpet events, parties,and fashion shows, she has just finished filming the lead role in ‘The Unforgettable’ and is starring in ‘Waterloo Road’ with Neil Morrisey. And if that wasn’t enough she is the first UN Asian Ambassador and has entertained the British Army around the world... And if that still wasn’t enough, Sofia is about to release the first single from her new album.

Many would have assumed that Sofia Hayat was leading the perfect life, but the entertainer still had something that bothered her: Her teeth.

Like many, she never enjoyed going to the dentist and as a result the state of her teeth had become

an embarrassment, and for most of her life, the resulting insecurities meant she rarely gave open mouthed smiles to photographers.

Sofia soon realised, that in order tocontinue her rise to the top, she would need to have a “Hollywood smile without coming across like a glamour model”. Even though dentists made her nervous, she decided to visit a few different ones to ask about teeth whitening for 3 reasons—she wanted her smile to be “approachable, stunning, and cheeky”.

After being told by several dentists that veneers were superior to simple teeth whitening, Sofia began to seriously look into cosmetic dentistry. Soon though, she began to realise that there is a

Celebrity Smile byHave you ever longed for a celebrity’s smile but felt it was beyond reach? Next time just remember one thing, even the rich and famous aren’t born perfect.

Before ▲ After▲

Before▲ After▲

“She wantedher smile to be“approachable,

stunning,and cheeky””

LXiR Harley Street

61 Harley Street

London W1G 8QU

Tel: 020 7255 1668

website: www.61harleyst.com

email: info@61harleyst.com

LXiR Birmingham

50-54 St Paul’s Square

Birmingham B3 1QS

Tel: 0121 233 0867

website: www.dazzlingsmile.co.uk

email:info@dazzlingsmile.co.uk

LXiR specialises in the Lumineers™ concept contact lens thin smile shapers▲

to ensure that their patients will be happy with the outcome. During that week her confidence already began to rise. “People will say you look better but won’t know why”, Sofia said. After receiving so many positive reactions in such a short time from the temporaries, she went ahead with the surgery.

Since then, her confidence has risen dramatically. “People still can’t figure out what has changed.” Sofia said, I’m often asked, “Have you had Botox?”, “Have you been on holidays?”, or even “Have you had our lips done?”.

But the actress doesn’t mind. When she is on the red carpet or at castings her new smile seems to

have boosted her esteem. She says, “I feel more confident”. As if she wasn’t gorgeous enough already, thanks to LXIR, Sofia Hayat, now has her own perfect teeth as well.

While praising and thanking Dr. Parag Patel, Dr Dinesh Vegad and Dr Kish Soneji from LXiR, Sofia said, “You guys are my Da Vinci and I’m your Mona Lisa.”

8

Redefining YouRself

and protecting with a good SPF such as factor 15.”

Ageing is no longer just about lines and wrinkles. “The last two years have seen an increased awa-reness of the ageing effects of pig-mentation and uneven skin tone,” notes Sarah Chapman. “An uneven skintone can be more ageing than lines themselves, which have the advantage of at least being percei-ved as interesting!” As such, many anti-ageing ranges and treatments focus on stimulating collagen pro-duction, helping repair UV damage and reducing uneven pigmentation

to give a clarity and glow to the skin.

When it is too late for prevention, modern dermatology has a solution. Vitamin A is the skincare ingre-dient most lauded by dermatologists and cosmeticians for its consistent effects at smoothing and brighte-ning skin, lifting pigmentation and eliminating lines. It is consistently reported as the most effective anti-ageing ingredient with the ability to repair DNA damage and cellular destruction and is the only FDA-approved anti-ageing ingredient. It is available in several forms, which penetrate the skin to different de-

and whose new Skinesis products, sold in Space NK, are founded on beating the effects of age by smoothing, lifting and brightening the skin.“We are all looking for the

perfect solution, and it is never too early to start.” For many dermato-logists, the consensus is that any fight against ageing begins with realising the present condition of

the skin and what that might indi-cate for the future. It is vital to be aware of what might lay beneath, latent only for now: much of our skin damage is done by the age of 18, especially through UV rays, and yet does not manifest itself un-til the 30s and onwards.

It’s for this reason that every pa-tient who comes to Dr Patrick Bow-ler undergoes a thorough skin MOT. Whether they enter his clinics for a full facelift or just Botox, every pa-tient is subjected to the scrutiny of a “skin-age camera”, which scans the layers of skin beneath the dermis

to detect damage and future pro-blems such as pigmentation. And yes: Dr Bowler admits that many of his patients do find it “terrifying, which is great: I get them to stick the camera’s print-out on their bathroom mirror at home. It’s the best possible reminder of why they should use their SPF 15 daily”.

He also prescribes a skincare routine, emphasising the classical but essential tenets of skincare – cleanse, moisturise and protect. “So many products are far too compli-cated these days,” says Dr Bowler. “They contain too much. Cleansing well is essential, as is moisturising

“Anti-ageing has been the biggest buzzword in skincare and cosmetic treatments for the last ten years,” says Sarah Chapman, a renow-ned London facialist for 16 years

Anti-ageing

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Holding back the yearsThe mantra of the modern skincare crusade is that prevention is better than cure – but also that cures are very available and can be extremely helpful.

“When it is too late for prevention, modern dermatology has a solution. Vitamin A is the ingredient most lauded for its consistent effects”

Lotions and potions are just one way to fight the effects of ageing - modern science offers many options▲

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Redefining YouRselfAnti-ageing

grees - retinol (alcohol), Retin-A (acid) or retinyl palmitate (an ester, or fat). Dr Bowler points out that the highest levels of vitamin A are at-tainable only through prescription, but for many it is enough to start at a lower level such as those found in brands founded by a professional but available without prescription such as Environ, Dr Brandt, or in Sarah Chapman’s Skinesis line, and then build up to a higher level.

“One of the biggest worries about ageing that I witness with my cli-ents concerns the slackening of skin around the jawline, the neck and on the eyelids, where the heaviness starts to give the appearance of clo-sing up the eyes,” says Sarah Chap-man. “Many of them would have blepharoplasty (eyelid lift) for this but I do a treatment called collagen induction therapy which stimulates fibroblast cells to produce more col-lagen and has a tightening effect on the skin. The other issue I see so much of now is uneven skin tone and pigmentation, mostly from clients doing too much to their skin and over use of peels and microderma-brasion. It actually has the opposite effect of making the skin look much older.”

Many dermatologists emphasise the importance of remembering that the skin is a living organ, and as such to treat skin concerns from the inside-out as much as the out-side-in. The London dermatologist and melanoma-specialist Dr Marko Lens underlines the importance of antioxidants, both topically applied and taken orally, to support the health of skin cells, their mainte-nance and growth.

“One of the biggest things that

women do wrong in their battle against age is to cut fat from their diet,” says Sarah Chapman. “But fat – the right kind, such as olive oil - has many benefits for skin. Essen-tial fatty acids and omega oils are

necessary for the health of every cell membrane to allow transport of nutrients and exchange of gases - when there is a lack of essential fats the cell walls tear and oils leak out leaving unbalanced skin.” Chapman advises taking a daily dose of 6,000mg of omega oil in the form of flaxseed oil.

Facial massage has been used for centuries as a staple skin treatment and can be easily incorporated in

to home routine: stimulating blood flow, feeding the skin with nutri-ents and aiding lymph drainage. As every dermatologist will point out, cleansing is often not done properly – and yet is a crucial part of looking after the skin because products can only work on clean, “blank” skin. “Keeping routines simple keeps you doing them,” says Sarah Chapman. “Choose an eye treatment, a serum that’s designed to allow better penetration of ac-tive ingredients and a treatment moisturiser or protective cream, and layer on in that order, daily. Use eye cream sparingly to avoid puffiness – the size of a grain of rice is enough - and smooth just up to the orbital bone (cheekbone). It will travel closer to the eye itself, beneath the skin.”

Every skincare professional agrees that many women change their skin routines too frequently, ever-searching for the perfect cream and led too heavily by advertising. It is more important to find the right ingredients in a range that offers potent doses of key ingredients – vi-tamin A, vitamin C and omegas - in order to see results and, most of all, you need to allow time for the skin

to alter at a cellular level before you see the effects on the surface, which will take at least a month.

For dermatologist Dr Christine Hoffmann, anti-ageing skincare is as much in diet technique as in what you eat and what you apply. “The condition of your skin and your di-gestion are intimately connected to one another: the worse the digestive performance of the intestines, the less attractive the skin,” she says. “Besides the liver and the kidneys, most of the body’s toxins are relea-sed via the skin. To purify your skin via your body means eat less, eat slowly and eat easily digestible me-als. Most crucially, not eating after 4pm will improve the condition and strength of your complexion by en-hancing the production of DHEA and Human Growth Hormone - the two hormones which are vital for the skin’s fight against ageing.”

It is also not just about the face. Too many people stop their moistu-riser application at the jawline but the skin on the neck is delicate and often the first to show ageing. It’s also worth remembering that many facelifts work from the hairline be-hind the ear – this is where much tightening can be achieved. Apply

moisturiser not to the neck, behind the ears and down to the top of the bust.

One of the key mistakes that pro-fessionals commonly see are the lack of use of products overnight – and yet this is when the skin is at its most rested and receptive, so a key time to slather on products.

Another is the contemporary obsession with accelerating the skin’s cycle of renewal using ma-nual or chemical exfoliants. While the benefits of exfoliation are well-known, smoothing the skin and making it more receptive to the benefits of products – and even the Ancient Egyptians were using pa-paya and pumice to shed old skin – there is a danger in overloading the skin with harsh aggressors that act to thin the skin prematurely.

As Chapman points out, “as we get older our skin thins anyway - constant use of “renewing” products means it will effectively age even faster. It should be used carefully and not more than advised by the manufacturer. Getting some lines is inevitable but if you keep the skin really healthy from the inside and moisturised and protected from the outside, you will look younger.”

• Avoid caffeine and sugar:

both are artificial stimulants

that send confusing messages

through the body and are very

ageing.

• Drink as much water as you

can.

• Eat oily fish or take flaxseed

or fish oils to increase omega/

essential fatty acid intake.

• Cleanse, moisturise and

protect with an SPF of at least

15 – every day.

• Apply moisturiser to neck and

behind ears as well as face.

Omega oils found in oily fish such as salmon are essential to healthy skin▲

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Redefining YouRself

trend that began in America – where spa revenues in 2007 were $10.9 bil-lion - but which has found firm foo-ting and favour here.

The lines between professional and at-home treatment, doctor and beautician, have long since blur-red: now, liposuction and lip im-plants are on the menu alongside

spray tans and manicures. Many spas will boast aesthetic nurses, nurse technicians, traditional beauticians and several permuta-tions in-between.

As the barriers come down, though, it is important to know what you are getting into – and with whom.

For Chapman, the value of the extras – from the oxygen facials to electric-current stimulation – depends on whose hands they are in, and on what else is being used, while Dr Patrick Bowler says the only person who should be permit-ted close to your face with a needle, for Botox or otherwise, is someone who is medically trained and licen-sed.

“Those Botox parties you hear about – they definitely happen,” he says. “But are they legal? No. Allow nobody to administer Botox or other injectables but a doctor or nurse trained in the procedure concerned.”

far more of a market than the altoge-ther more vague idea of pampering prettification.

The original concept of the spa involved something a little gentler than a chemical peel but the aim – to achieve improved health and appea-rance through physical treatment – was the same.

The word derives from the Bel-gian town of Spa, known for its he-

aling waters from the 17th century onwards. The term was later applied to anywhere that offered a natural spring, although the practice of en-gaging with healing waters dates back to the Romans.

Today, the very best spas offer a happy convergence between the se-rious science of the dermatologist’s consulting room and the pampering relaxation of home treatments – and,

best of all, in the hands of professi-onals.

New technologies have enriched the spa experience. For instance, in many clinics LED light has become a routine step of facials - the light can help calm inflammation and reduce redness after a client’s skin has been cleansed, extracted, and exfoliated.

Certain technologies are com-bined and used together for even better results; Sarah Chapman, a London facialist, uses an “iontopho-resis microcurrent” during facials in her Chelsea clinic because while her facial and massage alone be-stow a glow, the transdermal current can achieve something even better, lifting and plumping the skin: io-ntophoresis is a non-invasive and pain-free method of pushing high concentrations of an active sub-stance through the skin using a small electrical charge.

Champneys, a stalwart of the spa scene in the UK, now offers micro-dermabrasion, skin-resurfacing and the “Babor Power Lift and Collagen Facial”, alongside more traditional treatments.

The new titles claimed by some spas gives some evidence of how they see their new status – medi-spas, and medi-skin “clinics” abound. Like most developments in beauty, it’s a

It is no longer simply about feeling good. It is about achieving a result, to the extent that many proce-dures, such as chemical peels and Botox, formerly available only in a medical setting, are now widely accessible on the high street.

It’s an overtly American concept but one that is perhaps the best sui-ted to tough times: when the budget is tight, efficiency and efficacy have

Spas

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“The lines between professional and at-home treatment have long since blurred: liposuction is on the menu alongside manicures”

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The modern spa takes many different forms and offers many different treatments from holistic to high-science▲

12

Redefining YouRself

though Dr Rajiv Grover, secretary of the British Association of Aesthetic Plastic Surgeons, says that a dramatically noticeable increase in cup size will not be achieved.

“It’s the equivalent of a wearing a gel bra,” he says, and typically adds approximately half a cup size. The effect of Macrolane lasts about a year although it can cost around two-thirds the price of a full breast-augmentation operation.

“Macrolane is particularly good for lifting after breastfeeding,” says Dr Bowler of the British Association of Cosmetic Doctors. Macrolane can also be used for enhancing the calves and the buttocks to plump skin and give shape.

Advanced laser lipolysis, also known as Smartlipo, uses an advanced laser under local anaesthetic to remove excess fatty tissue via a small cannula from stubborn areas of the body that have been resistant to diet and exercise.

Like much in the cosmetic world, one person’s necessity is another’s excess; for some, a chemical peel is no more tolerable than a full eye-lift - and no knife does not necessarily mean no pain.

But minimally invasive treatments demand a lighter anaesthetic, take less time and leave fewer scars. Treatments for the face range from laser therapy to “smooth and brighten” and from fillers to “plump and shape” and peels to resurface the skin, while body-contouring involves targeting specific problem areas, commonly with laser therapy or fillers.

Macrolane is a new product related to the facial dermal filler Restylane, which has been used to treat facial lines and wrinkles for the past 12 years, and consists of hyaluronic acid, a synthetic version of a natural substance that the body normally produces.

It can be used to reshape the breast,

Of course, it sounds too good to be true, but minimally invasive treatment is the biggest growth area in aesthetic medicine.

Non-invasive procedures

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Cutting edge – without the knife

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Redefining YouRselfNon-invasive procedures

RESHAPING BODIES,TRANSFORMING LIVES

Dr Rita Rakus is hailed as the London Lip Queen – for good reason…

Over the past 15 years,Dr Rita Rakus has carvedout a reputation for being

among the best at what she does– non-surgical facial rejuvenationand body-shaping treatments. Hersensitive eye for contouring andsubtle volumising means her skillsare much sought after, particularly her lip-enhancing procedures,which have garnered her a hostof celebrity clients. She hasalso appeared on a number oftelevision programmes includingITV’s Under The Knife andCelebrity Fat Club, and Channel 4’s Lunch-hour Facelift.

MIND AND BODYDr Rakus takes a takes a holisticapproach to her work, consideringthe emotional needs of her clientsas important as the physicalchanges they’re looking to achieve.In doing so, she aims to ‘helppatients achieve their goals bygiving them more confidence’.

The clinic offers a wide rangeof anti-ageing and aesthetic bodytreatments from dermal fillers tolaser hair removal, plus the latestSmartLipo/Vaser, Thermage (for face, cellulite and body), Fraxel andMacrolane for breast enhancement.

LEADINg THE WAYDr Rakus is committed to the safeand professional practice withinthe world of aesthetic medicine.She is a founder member and afellow of the British Associationof Cosmetic Doctors (BACD). ‘Inhelping to found the BACD, weset out to regulate aestheticmedicine and provide patients withinformation regarding reputablepractitioners,’ says Dr Rakus. She isalso involved in training, lecturingand setting industry standards.

You can contact Dr Rakus at34a Hans Road, KnightsbridgeSW3 1RW. Call 020 7460 7324or visit www.drritarakus.com

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“It is for otherwise-slim people having trouble removing certain points of fat. It is not for making the overweight slim,” says Dr Bowler. It can be used on cheeks, the chin, the neck, upper arms, the waist (farewell “love handles”), thighs, hips, buttocks and knees. It boasts a recovery “down-time” of only two days and little scarring and bruising.

Dr Christine Hoffmann, a cosmetic dermatologist who practises in London and Vienna, recommends minimally invasive procedures

to her clients above simple topical treatment but before they consider surgery. “If someone really wants to see results, cosmetic products alone will not be enough,” she says.

“A typical treatment schedule for a patient of mine in their 40s or 50s would be Botox and fillers for deep wrinkles every three to four months. In-between he or she would see me either for a medical facial, which can incorporate a soft peel, or a treatment to supply hormones, hyaluronic acid, collagen and vitamins to the skin, depending

on its needs; or laser treatment for skin-resurfacing or to treat pigment

lesions or broken blood vessels.”It is important to remember that

no treatment, however minimally invasive, is not one-off but part of a routine. It will require maintenance, from every few months to every year.

And while no knives might mean a less dramatic procedure, minimally invasive treatment should not be undertaken lightly.

“There are a lot of pushy sales people out there, not to mention cowboys,” cautions Dr Bowler of the BACD. “Ask questions, ask to see case studies and pictures of results achieved.

“And never go for a permanent filler – if you don’t like the effect, you’re stuck with it.”

“It is important to remember that no treatment, however minimally invasive, is not one-off but part of a routine. It will require maintenance”

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Redefining YouRself

While some would argue that for men baldness can be an attractive look, the same is rarely said for women, yet for both sexes, stress and hormonal imbalance can cause hair loss, from partial to complete alopecia.

The good news is that most hair transplants appear to work in wo-men as well as they do in men. In

Get a head start on hair lossSince Samson and Delilah hair has symbolised youth, health, fertility and virility – and, for men and women, losing it can be devastating.

men, certainly, a degree of hair loss can be reversed with medication, according to The Trichological So-ciety: minoxidil (Rogaine/Regaine) or finasteride (Propecia). Minoxidil, known by the brand names Rogaine or Regaine, has also shown some positive effects in correcting female hair loss (research is still underway on the effects of finasteride, or Pro-pecia, on women).

But the most dramatic advan-ces in the fight against hair loss, however, have been in hair trans-plantation technology. The most significant development has been the “hair multiplication method”, pioneered in the Netherlands using

hair follicular stem-cell transplan-tation - or HST - which involves no incision and leaves no scarring.

“Hair stem-cell transplantation works on areas of the face as well as on the head… it can even reverse excessive hair removal – for instance on eyebrows – or grow a beard to cover scars”

Hair is a potent symbol, whatever your sex or hair colour: new advances now mean some hair loss can be reversed▲

Hair loss

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Redefining YouRselfHair loss

Crucially, it can be performed on areas of the face as well as on the head and has been found to be ef-fective at repairing hair loss caused by burn injuries and other trauma. It can even reverse excessive hair removal – for instance, on the eye-brows – or to grow a moustache or beard to cover facial scarring.

“Instead of moving hair, as is done in conventional hair trans-plants, HST is more analogous to budding and replanting new plants,” says Dr Coen Gho, the re-searcher and doctor who has initi-ated and steered the treatment in London and the Netherlands.

“By taking only some of the hair

stem cells away, the donor hair grows back where it was – so what we are really talking about is gro-wing new hair.”

Until now, the conventional cut-ting and laser methods were the only techniques available. Unfortu-nately, he says, “some of the results they produce can hardly be called natural and the man or woman is left with an unsightly scar in the donor area. Conventional tech-niques just move hair, so whatever hair you gain in one place is hair you lose somewhere else.”

The unique selling points of HST are that you can have hair grown back in the place or places that you

want it and the donor area is not da-maged. The biggest difference bet-ween HST and traditional methods is that HST requires only a small part of the hair follicle to be remo-ved – and, since most of the follicle remains behind, it will continue to produce new hair growth which can be potentially used as a donor area again in the future.

As Dr Gho says, hair shedding is a “social impediment and psycho-logical burden – it is not without cause that scientists have been see-king successful hair transplanta-tion techniques for generations”.

Hair loss can take many forms and have various causes, according

to the Trichological Society‘s web-site. Alopecia is the name given to all types of hair loss, and there are many different types – for example, alopecia areata, traction alopecia, post-partum alopecia, female and male pattern alopecia.

The latter two are often termed androgen-dependent, or androge-netic alopecia – a hair loss influ-enced by the presence of the male hormones, or androgens, in those with a genetic tendency. This is the most common kind and will affect only those who are genetically pre-disposed to it. The pattern of the hair loss differs according to the sex. In women, the thinning tends to start behind the front hairline and pro-gress over the top of the scalp; some women report thinning from the temples. In men the hairline recedes and the crown area thins, gradually progressing to involve the whole of the top of the scalp.

Post-partum or post-natal alope-cia is caused by hormonal changes during and after pregnancy, resul-ting in an increase of hair shed-ding about four to six months after giving birth. This is usually self-correcting by eight to ten months after the birth, according to the

Trichological Society. Traction alopecia is caused by

tension placed on the hair and scalp, most often through hairstyles or, as is increasingly seen, according to the Trichological Society, trauma to the scalp and hair through the use of hair extensions. Alopecia areata is spot-baldness that can happen quickly and without warning, and is thought to be caused by a com-bination of hereditary factors and circumstantial triggers such as emotional stress or illness, from hormonal disorders to cancer.

Nutritional supplements are thought to support hair growth and maintenance: studies have shown the significance of diet and the way it can affect hair can be dramatic. In some cases nutrition alone can be the cause of a hair loss problem.

Often a simple change in diet will have a beneficial effect on the hair. Hair consists of protein, so eating sufficient protein is vital to strong, healthy hair – combined with a ba-lanced diet and plenty of fruit and vegetables – while vitamins B, the minerals iron, biotin, selenium and silica and sea kelp have all been shown to have some positive effect on hair growth.

Fresh fruit and a balanced diet will support the maintenance of healthy hair▲